Gastric stapling: a significant risk factor in the treatment of tricyclic antidepressant overdose.

Attention is called to prior gastric stapling as a risk factor for emesis and aspiration in those patients who are treated with single or repeated oral activated charcoal for tricyclic antidepressant overdose. When administered activated charcoal as part of the standard protocol for drug poisoning, these individuals have the potential for developing severe and repeated emesis with subsequent aspiration of this compound into the respiratory tract with development of the Acute Lung Injury syndrome.